Antibacterial Property and Biocompatibility of Silver, Copper, and Zinc in Titanium Dioxide Layers Incorporated by One-Step Micro-Arc Oxidation: A Review

Abstract

Titanium (Ti) and its alloys are commonly used in medical devices. However, biomaterial-associated infections such as peri-implantitis and prosthetic joint infections are devastating and threatening complications for patients, dentists, and orthopedists and are easily developed on titanium surfaces. Therefore, this review focuses on the formation of biofilms on implant surfaces, which is the main cause of infections, and one-step micro-arc oxidation (MAO) as a coating technology that can be expected to prevent infections due to the implant. Many researchers have provided sufficient data to prove the efficacy of MAO for preventing the initial stages of biofilm formation on implant surfaces. Silver (Ag), copper (Cu), and zinc (Zn) are well used and are incorporated into the Ti surface by MAO. In this review, the antibacterial properties, cytotoxicity, and durability of these elements on the Ti surface incorporated by one-step MAO will be summarized. This review is aimed at enhancing the importance of the quantitative control of Ag, Cu, and Zn for their use in implant surfaces and the significance of the biodegradation behavior of these elements for the development of antibacterial properties.

Titanium Functionalized with Polylysine Homopolymers: In Vitro Enhancement of Cells Growth

“…To empower dental implant osteoinduction, the titanium surface can be functionalized by coating it with a series of bioactive compounds and substances. For this purpose, various coatings have been proposed: nanoparticles of silver, copper, and zinc, as sanitizing agents, and antibacterial and bioactive substances [14], such as quaternary ammonium ions and chlorhexidine, antibiotics, or antimicrobial peptides [15]; calcium-phosphate alone [16] or hydroxyapatite or octacalcium phosphate complexes [17]. These substances are used to make the titanium surface bioactive to improve osteoinduction, by adding, in some cases, antibacterial properties.…”

“…In addition to different surgical protocols [10], geometry modifications [5,11] and various surface treatments for increasing surface roughness [1,12], such as acid-etching, grit-blasting, titanium plasma-spraying, or anodization [13], as well as the use of various coatings to make the titanium surface bioactive [14][15][16][17] are responsible for empowering the wettability, bone anchoring, and biomechanical stability between the implant-bone interfaces [3,6,10,12,18], thus increasing osteoinduction and osteointegration.…”

Effectiveness of Antibacterial Surfaces in Osseointegration of Titanium Dental Implants: A Systematic Review

“…Such differences were attributed to possible dynamic bone formation and remodeling differences, especially in early healing intervals. A large number of in vitro and in vivo studies have revealed that, as well as good cytocompatibility, the addition of Sr and Ag to TiO 2 surfaces encourages strong antibacterial activity and accelerates new bone formation around the implant [ 47 , 48 , 49 , 50 ].…”

Toward Bactericidal Enhancement of Additively Manufactured Titanium Implants

“…When the antibacterial surface was soaked in normal saline for 28 days, the chemical states of the antibacterial active elements changed separately, leading to completely different changes in the antibacterial activity. The antimicrobial activity of the silver-coated specimens was gradually weakened, and Cu showed no significant change, while Zn showed enhanced antimicrobial activity [170].…”

“…It is a necessary trace element in the human body and participates in the synthesis of enzymes. Cu is less cytotoxic than Ag [170] and can be metabolized by the human body. Therefore, Cu may be an effective substitute for Ag.…”